SLE (SYSTEMIC LUPUS ERYTHEMATOSIS)
CHRONIC GENERALIZED IDIOPATHIC AUTOIMMUNE Dz WITH REMMITING AND RELAPSING COARSE WHICH LEADS TO A DIFFUSE VASCULITIS AND AFFECTS MULTIPLE ORGAN SYSTEMS–A CLINICAL AND SEROLOGIC DIAGNOSIS
1/2000
FEMALE 9:1
CHILDBEAREING AGE
CAN BE DRUG INDUCE (HYDRALAZINE, PROCAINAMIDE)
90% HAVE ARTHRITIS–ACUTE MIGRATING POLYARTHRITIS
33% + RF
MALAR “BUTTERFLY” RASH (50%)—FIXED ERYTHEMA, FLAT OR RAISED OVER THE MALAR EMINENCE—TENDING TO SPARE THE NASOLABIAL (MESOLABIAL) FOLDS
ERYTHEMOTOUS MACULAR PAPULAR RASH–MAY BE PRURITIC
PHOTOPHOBIA/PHOTOSENSITIVITY
NASAL SEPTAL PERFS OR ULCERATION
H&N OFTEN HAVE OME–CHL
ORAL ULCERS/ XEROSTOMIA, LEUKOPLAKIA FO THE TONGUE AND ORAL MUCOSA (ARTIFICIAL SALIVA/ KLACKS SOLUTION(TET, CORTISONE, BENEDRYL, NYSTATIN))
Dx: FANA/ANA
LE CELL = PMN WHICH HAS PHAGOCYTOSED A DAMAGED NUCLEUS
ANTI- Sm ANTIBODY—-ALSO OFTEN + SSA AND SSB
FALSE + VDRL
Bx : HEMATOXYLIN BODIES, ONOIN SKIN LESIONS ON THE ARTERIOLES OF THE SPLEEN, LIBMAN SACS, VERRUCOUS ENDOCARDITIS
Rx: STEROIDS, CHLORAQUINE—–ANTIMALARIAL WITH OPHTHO TOXICITY, MTX, PLAQUINIL
SUBACUTE CUTANEOUS LUPUS ERYTHEMATOSIS
CHRONIC DISCOID LUPUS ERYTHEMATOSIS— A SUB TYPE WITH CUTANEOUS LESIONS ONLY–10% GO ON TO DEV. SLE